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Figure 2: Steps of the orbital rim sparing single-piece fronto-orbital keyhole approach. Bidirectional high-speed drilling centered 5 mm behind the fronto-zygomatic suture (a) exposes the periorbita inferomedially (white arrow) and frontal dura superomedially (solid black arrow), with the lateral part of orbital roof in-between (b). The basic fronto-orbital cut from the burr hole over the periorbita, cutting parallel to and sparing the orbital rim (c). (d) shows full basal exposure to both subfrontal and orbital pathology. (e) displays the dural flap, and (f) exhibits the free bone flap with three cuts. Though self-fitting, fixation may be optional (g). Subcuticular suturing with good cosmesis is demonstrated in (h), and postoperative computed tomography showing the craniotomy in (i)

Figure 2: Steps of the orbital rim sparing single-piece fronto-orbital keyhole approach. Bidirectional high-speed drilling centered 5 mm behind the fronto-zygomatic suture (a) exposes the periorbita inferomedially (white arrow) and frontal dura superomedially (solid black arrow), with the lateral part of orbital roof in-between (b). The basic fronto-orbital cut from the burr hole over the periorbita, cutting parallel to and sparing the orbital rim (c). (d) shows full basal exposure to both subfrontal and orbital pathology. (e) displays the dural flap, and (f) exhibits the free bone flap with three cuts. Though self-fitting, fixation may be optional (g). Subcuticular suturing with good cosmesis is demonstrated in (h), and postoperative computed tomography showing the craniotomy in (i)